Eosinophilic colitis: experience in a large tertiary hospital

Area of Science:

• Gastroenterology
• Pathology
• Immunology

Background:

• Eosinophilic colitis (EC) is a rare gastrointestinal disorder with unclear causes and limited treatment options.
• Current histopathological criteria for EC lack specificity, leading to diagnostic challenges.
• This study aimed to refine diagnostic criteria for EC to improve clinical accuracy.

Purpose of the Study:

• To refine the diagnostic criteria for eosinophilic colitis (EC).
• To identify specific histopathological and clinical features that differentiate clinically diagnosed EC.
• To enhance the specificity of EC diagnosis.

Main Methods:

• A retrospective analysis of 106 cases diagnosed with EC between 2006 and 2016 was conducted.
• Clinical and pathological features of these cases were reviewed.
• Features distinguishing clinically confirmed EC were identified.

Main Results:

• A higher threshold of 40 eosinophils per high-power field (HPF) for both mean and maximum counts was identified.
• Elevated eosinophil counts (≥40/HPF) correlated with architectural distortion, mucosal atrophy, and eosinophil activation.
• Specific features like younger age, female gender, diarrhea, and absence of acute inflammation were associated with confirmed EC.

Conclusions:

• Histopathological diagnosis of EC shows poor correlation with clinical diagnosis.
• Increasing the cut-off to 40 eosinophils/HPF and integrating microscopic findings with clinical data improves EC diagnostic specificity.
• Refined criteria enhance the accuracy of diagnosing eosinophilic colitis.